Use of multifocal electroretinograms to determine stage of glaucoma

• Published in: PLOS ONE Vol. 18; no. 1; p. e0278234
• Main Authors: Moroto, Naoya, Nakakura, Shunsuke, Tabuchi, Hitoshi, Mochizuki, Kiyofumi, Manabe, Yusuke, Sakaguchi, Hirokazu
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science (PLoS) 12.01.2023; Public Library of Science
• Subjects: Acuity; Aged; Algorithms; Amplitudes; Asymmetry; Biology and Life Sciences; Care and treatment; Computer and Information Sciences; Consent; Diagnosis; Diameters; Electrodes; Electroretinograms; Electroretinography; Electroretinography - methods; Engineering and Technology; Evaluation; Glaucoma; Glaucoma, Open-Angle; Glaucoma, Open-Angle - diagnostic imaging; Hospitals; Humans; Kernels; Medical records; Medicine; Medicine and Health Sciences; Middle Aged; Nerve Fibers; Optics; Parameters; Physical Sciences; Q; R; Receptive field; Research and Analysis Methods; Research Article; Retinal Ganglion Cells; Science; Slopes; Social Sciences; Thickness; Tomography, Optical Coherence; Tomography, Optical Coherence - methods; Visual acuity; Visual field; Visual Field Tests; Visual Fields; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0278234

To determine whether multifocal electroretinograms (mfERGs) recorded with natural pupils and skin electrodes can be used to determine the stage of open angle glaucoma (OAG). Two hundred eighteen eyes of 132 OAG patients and 62 eyes of 62 normal subjects whose best-corrected visual acuity (BCVA) was 0.1 logarithm of the minimum angle of resolution (logMAR) units (20/25) or less were studied. The mean deviations (MDs) obtained by Humphrey Visual Field Analyzer (HFA), optical coherence tomographic (OCT) images, and mfERGs were analyzed. The glaucoma was classified into 4 stages: preperimetric glaucoma (PPG), early stage, moderate stage, and advanced stage glaucoma. The parameters of the mfERGs examined were the amplitudes of the two positive peaks (P1, P2) of the second order kernels in the nasal and temporal fields within the central 15° diameter. The mean age of all participants (patients and normals) was 63.8 ± 10.8 years. With the progression of glaucoma, the amplitudes of P1 in the nasal hemifield increased and the amplitudes of P2 decreased. The nasal to temporal ratio (N/T ratio) of the P1 amplitudes and the negative slope of the line between P1 and P2 (P1P2 Slope) in the nasal field were larger at each glaucoma stage except at the PPG stage. Both the N/T amplitude ratio and P1P2 Slope were weakly but significantly correlated with the MD (r = -0.3139, P<0.0001; r = 0.4501, P<0.0001, respectively), and the OCT parameters (all P<0.0001) except the outer layer thickness. Our findings indicate that the amplitudes of P1 and P2 of the second order kernel of the mfERGs in the nasal field of the center region can be good markers for the stages of glaucoma.